What Are Co-occurring Disorders?

The Substance Abuse and Mental Health Services Administration (SAMHSA) describes a co-occurring disorder as the coexistence of both a substance use disorder and a mental health disorder.  As of 2018, approximately 9.2 million adults in the U.S. had a co-occurring disorder, an increase of over 1.1 million people over three years. 

Co-occurring disorders can develop separately or simultaneously. The disorders may be different in severity, but the severity of either can change with time. The symptoms of the two illnesses often interact with each other, impacting the progression, prognosis, and treatment of the affected person. Sometimes, one disorder causes the other to worsen. 

Common Co-Occurring Disorders

There are many different combinations of co-occurring disorders. However, some combinations occur more often than others:

  • Alcohol addiction and panic disorder
  • Cocaine addiction and major depression
  • Drug addiction and schizophrenia
  • Alcohol addiction and schizophrenia
  • Post-traumatic stress disorder (PTSD) and drugs or alcohol
  • Anxiety and prescription medications such as Valium, Xanax, and Klonopin or alcohol

People with a substance use disorder are two times more likely to suffer from an antisocial personality disorder, anxiety disorder, or conduct disorder than people in the general population.

Bipolar disorders, mood disorders, psychotic illnesses, antisocial personality disorders, borderline personality disorders, conduct disorders, and eating disorders are other mental illnesses that commonly occur with substance use disorders.

Does One Disorder Cause the Other?

Although the prevalence of co-occurring disorders is high, it does not always mean one was caused by the other, even when one appeared first. It is often difficult to establish the cause of co-occurring disorders or time of onset. For example, an individual may not have a diagnosable anxiety disorder but still be driven to self-medicate their anxiety with alcohol or drugs. The substance use may, over time, worsen the anxiety to the point that it would be considered a disorder.

Many people with co-occurring disorders cannot remember which came first. It is common for a person abusing or addicted to alcohol or drugs to experience symptoms of anxiety, depression, psychosis, and others, which are also symptoms of mental illnesses. Or, someone suffering from a mental health disorder may experience anxiety or depression and self-medicate by drinking alcohol or using drugs.

The Three Most Likely Causes of Co-occurring Disorders

The Recovery Research Institute provides the three most likely causes of co-occurring disorders.

  1. Genetics: Certain genetic factors and vulnerabilities may increase the chances of a person developing both a mental illness and a substance use disorder. In addition, using substances may affect how specific genes act, called an epigenetic factor, causing changes in the genes’ behavior and environment. The changes may turn on or activate specific genes associated with mental health disorders. If the individual had not used the substances, the genes may not have been activated.
  2. Environment: A person may be more susceptible to both a mental health disorder and a substance use disorder if they experienced adolescent or childhood exposure to substance use; trauma, such as physical abuse, sexual abuse, or military combat; or other forms of severe stress.
  3. Developmental: During adolescence and young adulthood, mental health disorders and substance use disorders may occur if the person’s brain development experiences a dramatic change. For example, brain development can be affected by early exposure to using drugs or alcohol.

We Can Help

Because of the prevalence of co-occurring substance use disorder and mental health issues, it is essential to get the right help for both conditions. At English Mountain Recovery, located in the Smoky Mountains of eastern Tennessee, we understand co-occurring conditions and know how to address the underlying problems. We offer a specialized program to provide you with the help you need to feel better and live a sober life. Take the first step. Call us today.